You may be hearing a lot about “dense breasts” right now. That’s because on Sept. 10, an FDA requirement went into effect, which states that, after a mammogram, patients must be informed whether or not they have dense breasts.
JoAnn Pushkin
Executive Director, DenseBreast-info.org
Patients will also be informed that dense tissue makes it harder to find breast cancer on a mammogram, raises their risk of developing breast cancer, and that other imaging tests after a mammogram can help find cancers. Get educated.
Facts to know:
- Dense breast tissue is normal and common. 40% of women aged 40 and over have dense breasts.
- Dense breast tissue increases risk. Cancer is four to six times more likely to develop in women with extremely dense breasts than in women with the least dense breasts.
- Dense breast tissue hides cancers. Though mammograms find some cancers not seen on other screening tests, in extremely dense breasts, mammograms will miss about 40% of cancers.
- In dense breasts, after a mammogram, other screening tests, such as ultrasound or especially breast MRI, substantially increase detection of early-stage breast cancers.
Can I tell if I have dense breasts by the way my breasts look or feel?
No. Breast density refers to the tissue composition of your breasts and is determined by the doctor that reviews your mammogram.
How do I know if I have dense breasts?
When you have your mammogram, your breast density is rated as one of four categories:
- Fatty
- Scattered areas of fibroglandular density
- Heterogeneously dense
- Extremely dense
Breasts that are heterogeneously or extremely dense, are considered “dense” breasts.
How does dense tissue affect my mammogram?
Dense breast tissue is white on a mammogram and fatty tissue appears dark gray (see image). Unfortunately, cancers also display as white on a mammogram. If there is a lot of dense tissue on a mammogram, a cancer can be “hidden” among the dense tissue. This is true even if the mammogram is done with 3D/tomosynthesis.
For women with dense breasts, a “normal,” “negative,” or “benign” mammogram does not necessarily mean cancer is not present. No matter how recent your last mammogram, a lump or any changes in your breast should be brought to the attention of your health provider.
What about insurance coverage for additional testing?
Generally, if your health provider feels additional testing is medically necessary, it will be covered, though copay and deductibles may apply. Currently 34 states (see State Law Insurance Map) have passed insurance laws to cover some level of additional testing after a mammogram. However, state laws vary and coverage is not assured. To address state-by-state law variations, a federal insurance bill, the Find It Early Act, was introduced by Reps. DeLauro (D) and Fitzpatrick (R), and Sens. Klobuchar (D) and Marshall (R). The bill would help address insurance barriers to testing needed to find cancer at the earliest stage possible. Learn more at FindItEarlyAct.org.
